Term
| What is the nurse's role when intervening to reduce stress? |
|
Definition
| The nurse's role is to intervene to reduce stress by promoting a healing environment, facilitating successful coping, and developing future coping strategies. |
|
|
Term
| What is a psychological or physical stimuli that is incompatible with current functioning and requires adaptation? |
|
Definition
|
|
Term
| Who came up with the term fight-or-flight response? |
|
Definition
|
|
Term
| What concept is Hans Selye responsible for? |
|
Definition
| General adaptation syndrome (GAS) |
|
|
Term
| What are the three stages of General adaptation syndrome (GAS) |
|
Definition
1. Alarm
2. Resistance
3. Exhaustion |
|
|
Term
| In GAS what are the three principle responses during the alarm stage? |
|
Definition
1. Sympathetic - adrenalin is released
2. Corticosteriods - Adrenal cortex releases corticosteroids.
3. Endorphins - released to reduce sensitivity to pain and injury. |
|
|
Term
| What happens during the resistance (adaption) stage of GAS? |
|
Definition
| Sustained and optimal resistance to the stressor occurs. |
|
|
Term
| What happens during the exhaustion stage of GAS? |
|
Definition
| Occurs when attempts to resist the stressor prove futile. |
|
|
Term
| What is a negative, draining energy that results in anxiety, depression, confusion, helplessness, hopelessness, and fatigue? |
|
Definition
|
|
Term
| What is a positive, beneficial energy that motivates and results in feelings of happiness, hopefulness, and purposeful movement? |
|
Definition
|
|
Term
| Does the GAS model refer more to men or women? |
|
Definition
| Men... Women typically do not have the same fight or flight response that men do and instead develop a tending and befriending response. |
|
|
Term
| What is the brain catecholamine that plays an important role in mood, sleep, sexuality, appetite, and metabolism? |
|
Definition
|
|
Term
| What is the main neurotransmitters implicated in depression? |
|
Definition
|
|
Term
| What focuses on the interaction between psychological process and nervous and immune functions? |
|
Definition
|
|
Term
| How does stress effect the immune system? |
|
Definition
| Stress can enhance the immune system by signaling the release of cytokines. Eventually cytokines will trigger the release of corticosteroids which inhibit the immune system. |
|
|
Term
| What are the two categories of stressors? |
|
Definition
| Physical and psychological |
|
|
Term
| A person's _______ of a stressor determines that person's emotional and psychological reaction to it. |
|
Definition
|
|
Term
| What are the 7 mediators of the stress response? |
|
Definition
| Stressors, perception, individual temperament, Social support, support groups, culture, spirituality and religious beliefs. |
|
|
Term
| 6 effective stress busters? |
|
Definition
| sleep, exercise, reduction or cessation of caffeine intake, music, pets, and massage. |
|
|
Term
| What scale did Homes and Rahe publish in regards to measuring stress? |
|
Definition
| the Social Readjustment Rating Scale |
|
|
Term
| What does the Social Readjustment Rating Scale measure? |
|
Definition
| the level of positive or negative stressful life events over a one year period. |
|
|
Term
| What are Rahe's four identified coping styles? |
|
Definition
1. Health-sustaining habits
2. Life satisfactions
3. Social supports
4. Effective and healthy responses to stress |
|
|
Term
| What are the ten relaxation techniques for managing stress? |
|
Definition
1. Deep breathing exercises
2. Progressive muscle relaxation
3. Relaxation response
4. Meditation
5. Guided imagery
6. Biofeedback
7. Physical exercise
8. Cognitive reframing
9. Journaling
10. Humor |
|
|
Term
| What is the most common relaxation technique used in the United State? |
|
Definition
|
|
Term
| What relaxation technique involves deliberately tensing groups of muscles as tightly as possible for about 8 seconds and then releasing the tension you have created? |
|
Definition
| Progressive Muscle relaxation (PMR) |
|
|
Term
| What is a centuries old form of meditation that dates back to Buddhist tradition. |
|
Definition
|
|
Term
You are caring for a patient who is experiencing a crisis. Which symptoms would indicate that the patient is in the stage of alarm?
A. constricted pupils
b. dry mouth
c. decrease in heart rate
d. sudden drop in blood pressure |
|
Definition
|
|
Term
If it is determined that a patient will benefit from guided imagery, what teaching should you provide?
a. focus on a visual object or sound
b. become acutely aware of your breathing pattern
c. envision an image of a place that is peaceful
d. develop deep abdominal breathing |
|
Definition
| c. envision an image of a place that is peaceful |
|
|
Term
Neal, age 30, will be undergoing biofeedback. Which statement by Neal indicates a need for further teaching?
a. "this will measure my muscle activity, heart rate, and blood pressure."
b. "it will help me recognize how my body responds to stress."
c. "I will feel a small shock of electricity if I tell a lie."
d. "The instruments will know if my skin temperature changes." |
|
Definition
| b. it will help me recognize how my body responds to stress |
|
|
Term
Your patient asks you what the stress-relieving technique of mindfulness is. the best response is
a. focusing on an object and repeating a word
b. progressively tensing, then relaxing, body muscles
c. focusing on the here and now, not the past or future, paying attention to what is going on around you.
d. memory system to assist you in short term memory recall |
|
Definition
| c. focusing on the here and now, not the past or future, and paying attention to what is going on around you. |
|
|
Term
Which of the following are believed to help individuals mediate, or lessen, the effect s of stress (select all that apply)
spirituality/religion
wealth
higher education level
social support
culture |
|
Definition
spirituality and religion
social support
culture |
|
|
Term
| What is a universal human experience and is the most basic of emotions? It can be defined as a feeling of apprehension, uneasiness, uncertainty, or dread resulting from a real or perceived threat |
|
Definition
|
|
Term
| A reaction to a specific danger |
|
Definition
|
|
Term
| a healthy reaction necessary for survival. it provides the energy needed to carry out the tasks involved in living and striving toward goals. |
|
Definition
|
|
Term
| What are the four levels of anxiety according to Peplau's anxiety model? |
|
Definition
| Mild, moderate, severe, and panic |
|
|
Term
| Interventions are based on the ______ of the patient's anxiety |
|
Definition
|
|
Term
What level on Peplau's model of anxiety is the following:
occurs in the normal experience of everyday living and allows an individual to perceive reality in sharp focus. Involves nail biting, foot or finger tapping, and fidgeting. |
|
Definition
|
|
Term
What level on Peplau's model of anxiety is the following:
sees, hears, and grasps less information and may demonstrate selective inattention. Sympathetic nervous system becomes involved. symptoms include headache, heart pounding, urinary urgency, voice tremors, and shaking. |
|
Definition
|
|
Term
What level on Peplau's model of anxiety is the following:
learning and problem solving are not possible. dazed and confused. Nausea, dizziness, insomnia, and hyperventilation |
|
Definition
|
|
Term
What level on Peplau's model of anxiety is the following:
Most extreme level of anxiety. loses touch with reality. pacing, running, shouting, screaming, withdrawal, hallucinations, and can lead to exhaustion. |
|
Definition
|
|
Term
| Automatic coping styles that protect people from anxiety and maintain self-image by blocking feelings, conflicts, and memories. |
|
Definition
|
|
Term
| ______ use of defense mechanisms helps people lower anxiety to achieve goals in acceptable ways. |
|
Definition
|
|
Term
| _______ use of defense mechanisms occurs when one or several are used in excess, particularly in the overuse of immature defenses. |
|
Definition
|
|
Term
| What 3 things determine whether the use of a defense mechanism is adaptive or maladaptive? |
|
Definition
| frequency, intensity, and duration |
|
|
Term
| exhibit developmentally inappropriate levels of concern over being away from a significant other |
|
Definition
| separation anxiety disorder |
|
|
Term
| A profound disruption of a person's normal psychological homeostasis. |
|
Definition
|
|
Term
| The primary cause of a crisis |
|
Definition
|
|
Term
| How long does a crises usually last |
|
Definition
|
|
Term
| The outcome of crisis depends on what 3 factors |
|
Definition
1. the realistic perception of the event
2. adequate situational supports
3. adequate coping mechanisms |
|
|
Term
| a short term therapeutic process that focuses on the rapid resolution of an immediate crisis or emergency using available personnel, family , and environmental resources. |
|
Definition
|
|
Term
| The five essential, empirically supported elements of mass trauma interventions |
|
Definition
1. sense of safety
2. calming
3. sense of self-efficacy and collective efficacy
4. connectedness
5. hope |
|
|
Term
| The three types of crisis situations |
|
Definition
1. maturational (or developmental)
2. Situational
3. adventitious |
|
|
Term
| each of Erik Erikson's eight stages of ego growth and development represents a |
|
Definition
|
|
Term
| Arises from events that are extraordinary, external rather than internal, and often unanticipated. |
|
Definition
|
|
Term
| not a part of everyday life; it results from events that are unplanned and that may be accidental, caused by nature, or human made. |
|
Definition
|
|
Term
| 3 causes of an adventitious crisis |
|
Definition
1. natural disaster
2. national disaster
3. a crime of violence |
|
|
Term
| What is phase 1 of a crisis |
|
Definition
| when a person confronted by a conflict or problem that threatens the self concept responds with increased feelings of anxiety. The increase in anxiety stimulates the use of problem solving techniques and defense mechanisms in an effort to solve the problem and lower anxiety. |
|
|
Term
| What is phase 2 of a crisis |
|
Definition
| When the usual defensive response fails and the threat persists, anxiety continues to rise and produce feelings of extreme discomfort. Individual functioning becomes disorganized. Trial and error attempts at solving the problem and restoring a normal balance begin. |
|
|
Term
| What is phase 3 of a crisis |
|
Definition
| when the trial and error attempts fail, anxiety can escalate to severe and panic levels, and the person mobilizes automatic relief behaviors, such as withdrawal and flight. Some form of resolution may be made in this stage. |
|
|
Term
| What is phase 4 of a crisis |
|
Definition
| When the problem is not solved and new coping skills are ineffective, anxiety can overwhelm the person and lead to serious personality disorganization, depression, confusion, violence against others, or suicidal behavior. |
|
|
Term
| A person's equilibrium may be adversely affected by what three things |
|
Definition
1. an unrealistic perception of the precipitating event
2. inadequate situational supports
3. inadequate coping mechanisms |
|
|
Term
| At the resolution of a crisis, the patient will emerge at one of the three functional levels: what are the functional levels? |
|
Definition
1. a higher level of functioning
2. the same level of functioning
3. a lower level of functioning |
|
|
Term
| What is the main goal of a crisis intervention |
|
Definition
| to return the patient to at least the pre-crisis level of functioning |
|
|
Term
| What is the main difference between a crisis intervention and conventional therapeutic intervention in regards to the nurse's role |
|
Definition
| During a crisis intervention the nurse must be willing to take an active, even directive, role in intervention, which is in direct contrast to conventional therapeutic intervention that stresses a more passive and nondirective role. |
|
|
Term
| Is a crisis intervention considered psychotherapy or a preventative tool |
|
Definition
|
|
Term
| What are the four common problems with nurses when involved with a crisis intervention |
|
Definition
1. nurse needs to be needed
2. nurse sets unrealistic goals for patients
3. nurse has difficulty dealing with the issue of suicide
4. nurse has difficulty terminating the nurse-patient relationship |
|
|
Term
| What type of intervention involves education, environmental manipulation, or new coping skills |
|
Definition
|
|
Term
| What type of intervention involves crisis intervention |
|
Definition
|
|
Term
| What type of intervention involves rehabilitation |
|
Definition
|
|
Term
| Crisis intervention is a function of the basic-level nurse. The focus is on the present problem only and has what two initial goals? |
|
Definition
Patient safety
anxiety reduction |
|
|
Term
| Psychotherapeutic crisis interventions are directed toward what three levels of care? |
|
Definition
| primary, secondary, and tertiary |
|
|
Term
| Counseling level of care that promotes mental health and reduces mental illness to decrease the incidence of crisis. |
|
Definition
|
|
Term
| Counseling level of care that establishes intervention during an acute crisis to prevent prolonged anxiety from diminishing personal effectiveness and personality organization. |
|
Definition
|
|
Term
| ______ care provides support for those who have experienced a severe crisis and are now recovering from a disabling mental state. |
|
Definition
|
|
Term
| An example of a tertiary intervention directed toward a group that has experienced a crisis. |
|
Definition
| Critical incident stress debriefing |
|
|
Term
| 7 phases of a critical incident stress debriefing |
|
Definition
1. introductory
2. fact
3. thought
4. reaction
5. symptom
6. teaching
7. reentry |
|
|
Term
What Critical incident stress debriefing phase does the following represent:
Meeting purpose is explained, an overview of the debriefing process is provided. confidentiality is assured, guidelines are explained team members are identified and questions are answered. |
|
Definition
|
|
Term
What Critical incident stress debriefing phase does the following represent:
Participants discuss the facts of the incident, participants introduce themselves, tell their involvement in the incident, and describe the event from their perspective. |
|
Definition
|
|
Term
What Critical incident stress debriefing phase does the following represent:
Participants discuss their first thoughts of the incident |
|
Definition
|
|
Term
What Critical incident stress debriefing phase does the following represent:
Participants talk about the worst thing about the incident. What they would like to forget, and what was most painful. |
|
Definition
|
|
Term
What Critical incident stress debriefing phase does the following represent:
Participants describe their cognitive, physical, emotional, or behavioral experiences at the incident scene and describe any symptoms they felt following the initial experience. |
|
Definition
|
|
Term
What Critical incident stress debriefing phase does the following represent:
The normality of the expressed symptoms is acknowledged and affirmed. anticipatory guidance is offered regarding future symptoms. group is involved in stress management techniques. |
|
Definition
|
|
Term
What Critical incident stress debriefing phase does the following represent:
Participants review material discussed, introduce new topics, ask questions, and discuss how they would like to bring closure to the debriefing. debriefing team members answer questions, inform, and reassure. provide written material. provide information on referral sources and summarize the debriefing with encouragement, support and appreciation. |
|
Definition
|
|
Term
| Each catastrophic event will set in operation a five phase disaster management continuum including the following: |
|
Definition
1. Preparedness
2. Mitigation
3. Response
4. Recovery
5. Evaluation |
|
|
Term
Which disaster management continuum phase is the following:
The protective plan designed before the event to structure the response, assess risk, and evaluate damage. |
|
Definition
|
|
Term
Which disaster management continuum phase is the following:
Attempt to limit a disaster's impact on human health and community function. |
|
Definition
|
|
Term
Which disaster management continuum phase is the following:
Actual implementation of the disaster plan. |
|
Definition
|
|
Term
Which disaster management continuum phase is the following:
Actions focus on stabilizing the community and returning it to its previous status |
|
Definition
|
|
Term
Which disaster management continuum phase is the following:
Evaluating the response effort to prepare for the future |
|
Definition
|
|
Term
| How long does crisis intervention therapy typically last |
|
Definition
| It is short term: 1-6 weeks |
|
|
Term
| Crisis intervention therapy focuses on what? |
|
Definition
|
|
Term
| Crisis therapists take an ____ and _____ approach with the patient in crisis |
|
Definition
|
|
Term
| Specific qualities in the nurse that can facilitate effective intervention are a _____ attitude, _____ in planning care, an ability to ______, and an ______ approach |
|
Definition
caring
flexibility
listen
active |
|
|
Term
| What are the 8 defense mechanisms |
|
Definition
1. Displacement
2. Reaction formation
3. Undoing
4. Rationalization
5. Dissociation
6. Splitting
7. Projection
8. Denial |
|
|
Term
What defense mechanism is the following:
shifting feelings related to an object, person, or situation to another less threatening object, person , or situation. |
|
Definition
|
|
Term
What defense mechanism is the following:
Overcompensating or demonstrating the opposite behavior of what is felt. |
|
Definition
|
|
Term
What defense mechanism is the following:
Performing an act to make up for prior behavior. |
|
Definition
|
|
Term
What defense mechanism is the following:
Creating reasonable and acceptable explanations for unacceptable behavior. |
|
Definition
|
|
Term
What defense mechanism is the following:
Temporarily blocking memories and perceptions from consciousness |
|
Definition
|
|
Term
What defense mechanism is the following:
Demonstrating an inability to reconcile negative and positive attributes of self or others |
|
Definition
|
|
Term
What defense mechanism is the following:
Blaming others for unacceptable thoughts and feelings |
|
Definition
|
|
Term
What defense mechanism is the following:
Pretending the truth is not reality to manage the anxiety of acknowledging what is real. |
|
Definition
|
|
Term
| This level of anxiety is precipitated by an imminent loss or change that threatens one's sense of security. For example, the sudden death of a loved one. |
|
Definition
|
|
Term
| 3 Actions that promote patient growth |
|
Definition
1. attending
2. suspending value judgments
3. helping patients develop resources |
|
|
Term
| 3 personal characteristics of the nurse that help promote change and growth of patients. |
|
Definition
1. genuineness
2. empathy
3. positive regard |
|
|
Term
| 8 factors that progress a therapeutic relationship |
|
Definition
1. consistency
2. pacing
3. listening
4. initial impression
5. promoting patient comfort
6. balancing control
7. trust
8. active participation |
|
|
Term
|
Definition
1. summarizing goals and objectives achieved
2. discussing how to incorporate into daily life newly acquired coping strategies
3. reviewing situations that occurred during your relationship
4. exchanging memories |
|
|
Term
|
Definition
1. maintain the relationship
2. share information
3. gather further data
4. promote problem solving, self-esteem, and language
5. facilitate behavioral change
6. evaluate progress
7. support alternative adaptive behaviors |
|
|
Term
| 5 key components of the orientation phase |
|
Definition
1. establishing rapport
2. parameters of the relationship
3. formal or informal contract
4. confidentiality
5. terms of termination |
|
|
Term
| Who developed the nurse model of The Nurse-Patient Relationship |
|
Definition
|
|
Term
| What are the 4 phases of the model |
|
Definition
1. preorientation
2. orientation
3. working
4. termination |
|
|
Term
| Abstract standards that represent an ideal, either positive or negative |
|
Definition
|
|
Term
| Occurs when the nurse relates a patient to someone in their past. |
|
Definition
|
|
Term
| Occurs when the patient inappropriately transfers onto the nurse, feelings and behaviors related to significant figures in the patient's past. |
|
Definition
|
|
Term
| 3 types of boundaries in a relationship |
|
Definition
1. physical
2. contract
3. personal space |
|
|
Term
| A limited, but powerful encounter is referred to as |
|
Definition
|
|
Term
| 5 necessary behaviors of health care workers when establishing a therapeutic relationship |
|
Definition
1. accountability
2. focus on patient needs
3. clinical competence
4. delaying judgment
5. supervision |
|
|
Term
| A relationship where the nurse maximizes their communication skills, understanding of human behaviors, and personal strengths to enhance the patient's growth. |
|
Definition
|
|
Term
| a relationship that is primarily initiated for the purpose of friendship, socialization, enjoyment, or accomplishment of a task |
|
Definition
|
|
Term
|
Definition
1. intimate
2. social
3. therapeutic |
|
|
Term
| The ability to use one's personality consciously and in full awareness in an attempt to establish relatedness and to structure nursing intervention |
|
Definition
|
|
Term
| Care concepts of patient and family oriented care |
|
Definition
1. dignity and respect
2. information sharing
3. patient and family participation
4. collaboration in policy and program development |
|
|
Term
| Two major classification systems used to classify mental illness |
|
Definition
|
|
Term
| What is it called when you have more than one disorder at a time |
|
Definition
|
|
Term
| 6 key areas of care promoted by QSEN |
|
Definition
1. patient centered care
2. teamwork and collaboration
3. evidence based practice
4. quality improvement
5. safety
6. informatics |
|
|
Term
| 10 guiding principles of recovery |
|
Definition
1. self directed
2. individual person centered
3. empowering
4. holistic
5. nonlinear
6. strengths based
7. peer supported
8. respect
9. responsibility
10. hope |
|
|
Term
| in 1979, people with mental illness and their families created a group called |
|
Definition
| NAMI - national alliance on mental illness |
|
|
Term
| What model explains mental illness as nature and nurture |
|
Definition
|
|
Term
| Refers to all mental disorders with definable diagnoses |
|
Definition
|
|
Term
| A state of well being in which each individual is able to realize his or her own potential, cope with the normal stresses of life, work productively, and make a contribution to the community |
|
Definition
|
|
Term
| Physical movements such as posture |
|
Definition
|
|
Term
| Involves personal space, intimate distance, social distance, and public distance |
|
Definition
|
|
Term
| What are 3 steps for preparing for a patient interview |
|
Definition
1. pace
3. setting
4. seating |
|
|
Term
| What we use to listen to the cultures of the world around us |
|
Definition
|
|
Term
| 4 areas of communication that can be a problem when dealing with people of another culture |
|
Definition
1. communication style
2. use of eye contact
3. perception of touch
4. cultural filters |
|
|
Term
| 4 nontherapeutic communication techniques |
|
Definition
1. excessive questioning
2. giving approval or disapproval
3. giving advice
4. asking why questions |
|
|
Term
| 4 kind of questions a nurse uses to gain information from a patient |
|
Definition
1. open ended
2. closed ended
3. projective
4. presupposition |
|
|
Term
|
Definition
1. paraphrasing
2. restating
3. reflecting
4. exploring |
|
|
Term
| 4 useful tools for nurses when communicating |
|
Definition
1. silence
2. active listening
3. clarifying techniques
4. questions |
|
|
Term
| Two or more mutually contradictory messages given by a person in power |
|
Definition
|
|
Term
| a conflicting or mixed message |
|
Definition
|
|
Term
| The verbal message is sometimes referred to as the _______ of the message, and the nonverbal behavior is called the ______ |
|
Definition
|
|
Term
| Nonverbal cues and behaviors are examples of what |
|
Definition
| nonverbal communication and behavior |
|
|
Term
| 5 C's of verbal communication |
|
Definition
1. communicate our beliefs and values
2. communicate perceptions and meanings
3. convey interest and understanding
4. convey messages clearly
5. convey honest feelings |
|
|
Term
| 3 Factors that affect communication |
|
Definition
1. personal
2. environmental
3. relationship |
|
|
Term
| 3 steps of effective therapeutic communication |
|
Definition
1. knowing what they are trying to convey
2. communicating what is really meant to the patient
3. comprehending what the patient is conveying |
|
|
Term
| Peplau's two main principles to guide communication |
|
Definition
|
|
Term
| For hospice care a physician must determine that a patient has a life expectancy of ____ or less |
|
Definition
|
|
Term
| 6 Nursing goals for end of life care |
|
Definition
-Practice the art of presence
-Assess for spiritual issues
-Provide palliative symptom management
-Become an effective communicator
-Counsel about anticipatory grieving
-Practice good self-care |
|
|
Term
| The four gifts of resolving relationships |
|
Definition
1. forgiveness
2. love
3. gratitude
4. farewell |
|
|
Term
| Style of confronting the prospect of dying: What are the seven motifs |
|
Definition
1. Struggle - Living and dying are a struggle
2. Dissonance - dying is not living
3. Endurance - triumph of inner strength
4. Incorporation - belief system accommodates death
5. Coping - working to find a new balance
6. Quest - seeking meaning in dying
7. Volatile - unresolved and unresigned |
|
|
Term
The reaction to loss...
- Includes depressed mood, insomnia, anxiety, poor appetite, loss of interest, guilt, dreams about the deceased, poor concentration |
|
Definition
|
|
Term
| Period of grieving following death |
|
Definition
|
|
Term
| Things people do to cope with grief |
|
Definition
|
|
Term
| 4 loss oriented stressors |
|
Definition
1. Concentrating on the loss experience
2. Feeling the pain of grief,
3. remembering
4. longing |
|
|
Term
| 4 restoration oriented stressors |
|
Definition
1. overcoming loneliness
2. mastering skills and roles once performed by the deceased
3. finding a new identity
4. facing practical details of life |
|
|
Term
|
Definition
1. accept the reality of the loss
2. experience the pain of grief
3. adjust to an environment without the loved one
4. relocate and memorialize the loved one |
|
|
Term
| 4 tasks of maladaptive grieving |
|
Definition
1. chronic grief
2. delayed grief
3. exaggerated grief
4. masked grief reactions |
|
|
Term
| Four constructs that support personal growth |
|
Definition
1. seeing some good resulting from the death
2. continuing the connection with the deceased
3. invoking intrinsic spirituality to understand the death and aftermath
4. going forward with life |
|
|
Term
| is one of the most common mental disorders, affecting approximately 13 million adults annually in the United States. |
|
Definition
| major depressive disorder |
|
|
Term
| To be diagnosed with major depressive disorder, you must be consistently showing signs and symptoms for how long |
|
Definition
|
|
Term
| What is bereavement exclusion |
|
Definition
| The first two months following a significant loss |
|
|
Term
| What is disruptive mood dysregulation disorder |
|
Definition
| relates to children between the ages of 6 and 18 and refers to situations in which a person has frequent temper tantrums resulting in verbal or behavioral outbursts out of proportion to the situation |
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|
Term
| What is dysthymic disorder |
|
Definition
| occurs when feelings of depression persist consistently for at least two years. |
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|
Term
| What is premenstrual dysphoric disorder |
|
Definition
| refers to a cluster of symptoms that occur in the last week prior to the onset of a woman's period. symptoms decrease significantly or disappear with the onset of menstruation. |
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|
Term
| What is substance-induced depressive disorder |
|
Definition
| applies when symptoms of a major depressive episode arise as a result of prolonged drug or alcohol intoxication or as the result of withdrawal from drugs and alcohol. |
|
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Term
| What is the leading cause of disability in the United States |
|
Definition
|
|
Term
True or False
Depression is a normal result of aging |
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Definition
| False.. Although it is common, it is not considered normal |
|
|
Term
| 6 Major depressive disorder subtypes |
|
Definition
1. Psychotic features
2. Melancholic features
3. atypical features
4. catatonic features
5. postpartum onset
6. seasonal features - seasonal affective disorder (SAD) |
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|
Term
| Primary risk factors for depression |
|
Definition
-female gender
-unmarried
-low socioeconomic class
-early childhood trauma
-the presence of a negative life event, especially loss and humiliation
-family history of depression, especially in first degree relatives
-ineffective coping ability
-postpartum time period
-medical illness
-absence of social support
-alcohol or substance abuse |
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Term
| Research indicates that stress is associated with a reduction in ______, which is the ability of the brain to produce new brain cells. |
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Definition
|
|
Term
| Two of the main neurotransmitters associated with depression |
|
Definition
| nor epinephrine and serotonin |
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|
Term
| Biological factors that contribute to depression |
|
Definition
Genetics
Biochemicals
alteration in hormonal regulation
inflammatory response
diathesis-stress model |
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|
Term
| What is the diathesis-stress model |
|
Definition
| a model of depression that takes into account the interplay between genetic and biological predisposition toward depression and life events. |
|
|
Term
| What does the cognitive theory state |
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Definition
| that the underlying assumption is that a person's thoughts will result in emotions. if you think positive you will be positive. |
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Term
| The three assumptions of Beck's triad |
|
Definition
1. a negative, self-deprecating view of self
2. a pessimistic view of the world
3. the belief that negative reinforcement will continue in the future. |
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Term
|
Definition
|
|
Term
|
Definition
| lack of energy or physical passivity |
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|
Term
| _______ agitation may be evidenced by constant pacing and wringing of hands |
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Definition
|
|
Term
| psychomotor ________ are slowed movements |
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Definition
|
|
Term
| _______ signs of depression include change in bowel movements and eating habits, sleep disturbances, and disinterest in sex. |
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Definition
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Term
| is an outward representation of a person's internal state of being and is an objective finding based on the nurse's assessment |
|
Definition
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|
Term
| The 3 phases in treatment and recovery from major depression |
|
Definition
1. Acute phase (6 to 12 weeks) - is directed at reduction of depressive symptoms and restoration of psycho-social and work function. Hospitalization may be required, and medication or other biological treatments may be initiated.
2. Continuation phase (4 to 9 months) - is directed at prevention of relapse through pharmacotherapy, education, and depression-specific psychotherapy.
3. Maintenance phase (1 year or more) - is directed at prevention of further episodes of depression. Depending on the risk factors for relapse, medication may be phased out or continued. |
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Term
| All antidepressants work to increase the availability of one or more of what 3 neurotransmitters |
|
Definition
| serotonin, dopamine, norepinephrine |
|
|
Term
| are recommended for first line therapy for most types of depression |
|
Definition
| SSRI's selective serotonin reuptake inhibitors |
|
|
Term
| a rare and life threatening event associated with SSRI's |
|
Definition
|
|
Term
| The risk of serotonin syndrome is greatest when mixing an SSRI with a ___________ |
|
Definition
| MAOI monoamine oxidase inhibitor |
|
|
Term
| The risk of serotonin syndrome is greatest when mixing an SSRI with a ___________ |
|
Definition
| MAOI monoamine oxidase inhibitor |
|
|
Term
| This antidepressant drug selectively blocks the neuronal uptake of serotonin, which increased the availability of serotonin in the synaptic cleft |
|
Definition
| selective serotonim reuptake inhibitors (SSRI) |
|
|
Term
| This antidepressant drug selectively blocks the neuronal uptake of serotonin, which increased the availability of serotonin in the synaptic cleft |
|
Definition
| selective serotonim reuptake inhibitors (SSRI) |
|
|
Term
| This antidepressant drug works by inhibiting the reuptake of norepinephrine and serotonin by the presynaptic neurons in the CNS, increasing the amount of time norepinephrine and serotonin are available to the postsynaptic receptors. |
|
Definition
| Tricyclic antidepressants (TCA) |
|
|
Term
| When taking an MAOI, the patient should avoid foods that contain high amounts of ________ |
|
Definition
|
|
Term
| What is the most serious reaction caused by the use of MAOI's? |
|
Definition
| I spike in blood pressure that can lead to intracranial hemorrhage |
|
|
Term
| What vital sign would you want to monitor closely during the first 6 weeks with a patient being treated with an MAOI |
|
Definition
|
|
Term
| Foods you should avoid when taking MAOI's |
|
Definition
| avocados, soybeans, figs, bananas, fermented and smoked meats,liver, sausage, aged fish, all cheeses, yeast, beer, wine, protein supplements, chocolate, fava beans, ginseng, caffeine. |
|
|
Term
| Is it safe for pregnant women to use antidepressants |
|
Definition
| a study showed that antidepressant use during pregnancy is relatively safe |
|
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Term
|
Definition
| a patient with bipolar disorder who has many episodes of mood swings close together (4 or more in a year) |
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|
Term
| What is transcranial magnetic stimulation (TMS) |
|
Definition
| a noninvasive treatment modality that uses MRI-strength magnetic pulses to stimulate focal areas of the cerebral cortex. |
|
|
Term
| What is transcranial magnetic stimulation (TMS) |
|
Definition
| a noninvasive treatment modality that uses MRI-strength magnetic pulses to stimulate focal areas of the cerebral cortex. |
|
|
Term
| What is Vagus nerve stimulation (VNS) |
|
Definition
| a pulse generator is implanted in the chest while a wire is attached to the vagus nerve in the neck. The pulses generator have shown to boost the levels of neurotransmitters and improving mood in depressed people. |
|
|
Term
| What is deep brain stimulation (DBS) |
|
Definition
| a treatment whereby electrodes are surgically implanted into specific areas of the brain in order to stimulate those regions identified to be under active in depression. |
|
|
Term
| what does light therapy treat |
|
Definition
| people with seasonal affective disorder (SAD) |
|
|
Term
Light therapy:
Exposure to light is thought to be effective because of the influence of light on _________ |
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Definition
|
|
Term
| What type of mania feels wonderful in the beginning, but it turns scary and dark as it progresses toward loss of control and confusion |
|
Definition
|
|
Term
| What type of mania is also referred to as a fixed state or agitated depression, with depressive symptoms along with mania. |
|
Definition
|
|
Term
| A mood disorder that is characterized by at least one week long manic episode that results in excessive activity and energy |
|
Definition
|
|
Term
| Which disorder is characterized by low level mania (hypomania) alternating with profound depression |
|
Definition
|
|
Term
| Symptoms of hypomania alternate with symptoms of mild to moderate depression for at least two years in adults and one year in children. |
|
Definition
|
|
Term
| What disorder is hard to distinguish from Bipolar II |
|
Definition
|
|
Term
| are bipolar disorders inheritable |
|
Definition
| yes, they have an 80-90% heritability |
|
|
Term
| What drug is the first line therapy for someone with bipolar disorder |
|
Definition
|
|
Term
| a nearly continuous flow of accelerated speech with abrupt changes from topic to topic that are usually based on understandable associations or plays on words. |
|
Definition
|
|
Term
| The stringing together of words because of their rhyming sounds, without regard to their meaning |
|
Definition
|
|
Term
| are delusions and hallucinations present during hypomania |
|
Definition
|
|
Term
| The primary outcome of the acute phase of bipolar disorder is |
|
Definition
|
|
Term
| How long does the continuation phase of bipolar disorder last |
|
Definition
|
|
Term
| What is the overall outcome for the continuation phase |
|
Definition
|
|
Term
| What is the overall outcome for the maintenance phase |
|
Definition
|
|
Term
| When someone is in the acute phase and having a depressive episode, is the use of antidepressants recommended |
|
Definition
| no, it can cause the patient to go into hypomania or mania |
|
|
Term
| What is lithium carbonate used for |
|
Definition
| bipolar I acute and recurrent manic and depressive episodes |
|
|
Term
| How long does it take for lithium to reach its therapeutic window |
|
Definition
|
|
Term
| How long does it take for lithium to reach its therapeutic window |
|
Definition
|
|
Term
| What drugs are used while waiting for lithium to reach therapeutic levels in the blood |
|
Definition
| antipsychotics or benzodiazepines |
|
|
Term
| What is your main concern when someone is presenting an acute manic episode |
|
Definition
| That they are going to work themselves into an exhaustive state that can eventually lead to death |
|
|
Term
| During the active phase at what dose is lithium given |
|
Definition
| 300 mg to 600 mg 2 or 3 times per day by mouth to reach a clear therapeutic result or a lithium level of 0.8 to 1.4 mEq/L |
|
|
Term
| What range should the maintenance blood levels of lithium be at |
|
Definition
|
|
Term
| at what serum level does lithium begin to show signs of toxicity |
|
Definition
|
|
Term
| At what serum level do advanced signs of lithium toxicity appear |
|
Definition
|
|
Term
| at what serum level of lithium is someone severe or close to death |
|
Definition
|
|
Term
| When should blood be drawn when testing for maintenance lithium levels |
|
Definition
| in the morning 8 to 12 hours after the last dose of lithium was taken. |
|
|
Term
| What instructions should the patient and family receive in regards to taking lithium |
|
Definition
1. the purpose and requirements of lithium therapy
2. its adverse effects
3. its toxic effects and complications
4. situations in which the physician should be contacted |
|
|
Term
| What are the major long term effects of lithium use |
|
Definition
| hypothyroidism and impairment of the kidney's ability to concentrate urine |
|
|
Term
| What 3 anticonvulsants are used in the treatment of bipolar disorder |
|
Definition
valproate (depakote)
carbamazepine (tegretol)
lamotrigine (lamictal) |
|
|
Term
| What drug should be prescribed to someone that has a cycling disorder... lithium or an anticonvulsant |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is lithium's effects on electrolyte levels |
|
Definition
| lithium decreases sodium reabsorption in the kidneys, which could lead to a deficiency of sodium |
|
|
Term
| What type of diet is NOT recommended for someone who is taking lithium |
|
Definition
|
|
Term
| A patient is on lithium and has excessive diarrhea, vomiting, or sweating. What should they do |
|
Definition
| Stop taking their lithium and contact their physician |
|
|
Term
| Should someone take lithium with meals or on an empty stomach |
|
Definition
|
|
Term
| What are the three main elements hat must be considered when evaluating lethality of a suicide plan |
|
Definition
1. is there a specific plan with details
2. how lethal is the proposed method
3. is there access to the planned method |
|
|
Term
| What does SADPERSONS stand for |
|
Definition
S sex
A age
D depression
P past attempts
E ethanol use
R rational thinking loss
S social supports lacking
O organized plan
N no spouse
S sickness |
|
|
Term
What do the following ratings on the SAD PERSONS scale represent:
0-2
3-4
5-6
7-10 |
|
Definition
0-2 - send home with follow-up
3-4 - closely follow up; consider hospitalization
5-6 - strongly consider hospitalization
7-10 - Hospitalize or commit |
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|
Term
| _____ intervention includes activities that provide support, information, and education to prevent suicide. |
|
Definition
|
|
Term
| ______ intervention is treatment of actual suicidal crisis |
|
Definition
|
|
Term
| _______ intervention (or postvention) refers to interventions with the circle of survivors of a person who has completed suicide. |
|
Definition
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